Dilution is not the solution: acute hemolytic transfusion reaction after ABO-incompatible pooled platelet transfusion

Abstract

The short shelf life of platelets makes providing ABO-compatible platelets a challenge, and many institutions issue ABOincompatible platelets when compatible units are not available. It is presumed that ABO antibodies that exist in donor plasma are diluted when platelets from multiple donors are combined to make a pooled product for transfusion. We present a case of a hemolytic transfusion reaction in a 73-year-old man with myelodysplastic syndrome who received an ABO-incompatible pooled platelet unit. This case report demonstrates that the dilution theory is not always true for pooled platelet units, and any patient receiving ABO-incompatible platelet transfusions must be closely monitored for potential hemolytic transfusion reactions. Immunohematology 2019;35:91-94.